Anemia and Nutrition: The Importance of Essential Vitamins

(Extraído de National Anemia Action Council)

NAAC Article Published: October 9, 2008

Vitamins are the nutrients that are found in foods we eat. Your body needs them to grow, develop and work properly. When it comes to vitamins, each one has a special role to play. For example, folic acid is necessary for DNA synthesis and very important in the making of red and white blood cell production.¹ Vitamin B12 is also needed for blood cell production as well as for maintaining healthy nerves.² B vitamins in general help your body make protein and energy.

In addition to vitamin B12 and folic acid, you also need iron in order to produce healthy red blood cells. Red blood cells carry oxygen from your lungs to all parts of your body. Without enough vitamin B12 and folic acid, your red blood cells become large and underdeveloped. This causes your body to produce fewer cells, and the cells die earlier than the 120-day life expectancy.³ Consequently, your blood can become low on red blood cells; a condition called vitamin deficiency anemia.⁴

The most common types of vitamin deficiency anemia are vitamin B12 deficiency anemia and folic acid (folate) deficiency anemia.⁴ Vitamin B12 deficiency anemia and folate deficiency anemia usually develop when your body is unable to absorb enough of these vitamins from the food you eat. Elderly people and pregnant women run the greatest risk of developing these anemias. People can develop low levels of these important vitamins in several different ways. Some of these causes are outlined in the list below.⁵

Causes of Vitamin B12 Deficiency Anemia:

• Lack of vitamin B12 – Not enough vitamin B12 in your diet can occur if you are on a strict vegetarian diet.
• Intestinal disorders – Some disorders, such as Crohn’s disease and intestinal infections, can inhibit the absorption of vitamin B12.
• Lack of intrinsic factor – Lacking the stomach protein intrinsic factor is the most common cause of vitamin B12 deficiency. It helps receptors absorb vitamin B12, but the cells that produce it can be destroyed by your immune system or from stomach surgery.

Causes of Folate Deficiency Anemia:

• Lack of folic acid – Not enough folic acid in your diet can occur if your diet lacks fresh fruits and vegetables, you consistently overcook your food, or drink too much alcohol.
• Intestinal disorders – Some disorders, such as Crohn’s disease and intestinal infections, can interfere with the absorption of folic acid.
• Prescription medications – Certain medications, such as some anti-seizure drugs, can block absorption of folic acid.

People suffering from vitamin B12 deficiency anemia or folate deficiency anemia feel tired and weak and can have a bright red, smooth tongue. Vitamin B12 deficiency can affect your nerves and you may experience tingling and numbness in the hands and feet. It can also cause confusion, depression, poor concentration and forgetfulness. Without treatment, these symptoms will develop slowly and become more severe over time.⁵

Symptoms of Vitamin Deficiency

• Feeling tired and weak
• Having a bright red, smooth tongue
• Possible tingling and numbness in the hands and feet
• Confusion, poor concentration, forgetfulness or depression

It is important to note that with vitamin B12 deficiency anemia, it is much more difficult for the body to absorb vitamin B12 from food or pills. Fortunately, your doctor can easily treat both vitamin B12 deficiency anemia and folate deficiency with the proper supplements, and most if not all of these symptoms will disappear when the vitamin deficiency is corrected.

Doctors diagnose vitamin deficiency anemias through blood tests. These tests measure the level and appearance of red blood cells. When you are anemic, you have fewer red blood cells. If you have a vitamin deficiency anemia, your red blood cells can be large and oval instead of being round and disc-shaped. Blood tests also include a check of the amount of folic acid and vitamin B12 in your blood.

Preventing Vitamin Deficiencies

You can prevent some forms of vitamin deficiency anemia by eating a balanced diet and taking a multivitamin every day. According to Valerie Reynolds MS, RD, LDN, a registered dietician at the University of Chicago Hospital, “ The American Medical Association recommends that everyone take a daily multivitamin. Multivitamins help bridge the gap between the nutrients we get from food, and what your body actually needs on a daily basis. This practice is probably the best form of prevention against the development of a vitamin deficiency anemia.”

Folate-Rich Foods

• Citrus fruits and juices
• Enriched breads, cereals & grains
• Dark green leafy vegetables

Vitamin B12-Rich Foods

• Fish, meat, poultry & eggs
• Milk and milk products

Daily Vitamin Requirements

Vitamin	Adults	Pregnant Women
Vitamin B12	2.4 mcg	2.4 mcg
Folate (Folic Acid)	400 mcg	600 mcg

Most adults need these amounts in micrograms.
NIH. Dietary Fact Sheets: Folate,¹ Vitamin B12²
Mayo Clinic: Vitamin Deficiency Anemia.⁴

Vitamin B12 is naturally found in foods that come from animals, including fish, meat, poultry, eggs, milk, and milk products. Fortified breakfast cereals are a particularly valuable source of vitamin B12.² Foods rich in folate include citrus fruits and juices and dark green leafy vegetables. In 1996, the U.S. Food and Drug Administration (FDA) published regulations requiring the addition of folic acid to enriched breads, cereals, flours, corn meals, pastas, rice, and other grain products. These products are a major source of folic acid in our diet.¹ A healthy balanced diet will provide adequate amounts of these vitamins for most people. Pregnant women however, require more folic acid than most healthy diets contain.

Pregnant women need an adequate supply of folic acid in order for the baby to develop properly. Since it is most important to have the folate in your system at the time of conception, women in their childbearing years should take a multivitamin containing folic acid (400 micrograms) because most women only receive 200 micrograms daily from their diet. Folic acid reduces the chance for certain birth defects to occur (such as spina bifida and cleft lip/palate) when taken before and during the early part of pregnancy.¹

If left untreated, vitamin deficiency anemia can lead to other health problems. You can usually correct vitamin deficiency anemia with supplements and dietary changes. If you think you may have anemia, we recommend you see your healthcare professional. Close communication with your doctor will help him or her provide the treatment that is best for you based on what is causing the anemia.

References

1. National Institute of Health, Office of Dietary Supplements. Dietary Supplement Fact Sheet: Folate. Link.
2. National Institute of Health, Office of Dietary Supplements. Dietary Supplement Fact Sheet: Vitamin B12. Link.
3. New York-Presbyterian Hospital. Health Library: Anemia of Folate Deficiency. Link.
4. Mayo Clinic. Health Information: Vitamin Deficiency Anemia. Link.
5. Heart Lung and Blood Institute. Diseases and Conditions Index: Pernicious Anemia. Link.